Beyond QuantiFERON-TB Results, the Added Value of a Weak Mitogen Response
Copyright © 2022 Jacquier, Binquet, Manoha, Audia, Simonet-Lamm, Casenaz, Sow, Piroth and Blot..
Introduction: While QuantiFERON-TB gold (QFT) is frequently used, little attention is paid to the mitogen response. How it could be impacted and associated with outcomes is poorly known.
Methods: Retrospective, case-control study in hospitalized patients who underwent QFT testing in two hospitals between 2016 and 2019. We defined two groups of cases with either negative [interferon (IFN)-γ ≤ 0.5 IU/ml, official threshold] or weak (0.5-2 IU/ml) mitogen response, and one group of controls with normal (>2 IU/ml) mitogen response.
Results: A total of 872 patients were included. An ongoing infection was independently associated with both a negative (RR = 4.34; 95% CI = 2.94-6.41) and a weak mitogen response (RR = 2.44; 95% CI = 1.66-3.58). Among tuberculosis patients, a weak mitogen response was associated with a false-negative QFT result (75%) compared to a normal response (20%). Decreasing mitogen response (normal, weak and negative, respectively) was associated with increasing length of hospital stay [median (interquartile range) 5 (3-13), 11 (5-21) and 15 (10-30) days; p < 0.001] and increasing hospital mortality (3, 7, and 15%; p < 0.001).
Conclusion: Clinicians should take notice of the mitogen response since IFN-γ concentrations lower than <2 IU/ml were associated with false-negative QFT results in tuberculosis patients, independently associated with ongoing infections, and could be associated with worse prognosis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:9 |
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| Enthalten in: |
Frontiers in medicine - 9(2022) vom: 17., Seite 876864 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jacquier, Marine [VerfasserIn] |
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| Anmerkungen: |
Date Revised 16.07.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.3389/fmed.2022.876864 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM342334433 |
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| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Copyright © 2022 Jacquier, Binquet, Manoha, Audia, Simonet-Lamm, Casenaz, Sow, Piroth and Blot. | ||
| 520 | |a Introduction: While QuantiFERON-TB gold (QFT) is frequently used, little attention is paid to the mitogen response. How it could be impacted and associated with outcomes is poorly known | ||
| 520 | |a Methods: Retrospective, case-control study in hospitalized patients who underwent QFT testing in two hospitals between 2016 and 2019. We defined two groups of cases with either negative [interferon (IFN)-γ ≤ 0.5 IU/ml, official threshold] or weak (0.5-2 IU/ml) mitogen response, and one group of controls with normal (>2 IU/ml) mitogen response | ||
| 520 | |a Results: A total of 872 patients were included. An ongoing infection was independently associated with both a negative (RR = 4.34; 95% CI = 2.94-6.41) and a weak mitogen response (RR = 2.44; 95% CI = 1.66-3.58). Among tuberculosis patients, a weak mitogen response was associated with a false-negative QFT result (75%) compared to a normal response (20%). Decreasing mitogen response (normal, weak and negative, respectively) was associated with increasing length of hospital stay [median (interquartile range) 5 (3-13), 11 (5-21) and 15 (10-30) days; p < 0.001] and increasing hospital mortality (3, 7, and 15%; p < 0.001) | ||
| 520 | |a Conclusion: Clinicians should take notice of the mitogen response since IFN-γ concentrations lower than <2 IU/ml were associated with false-negative QFT results in tuberculosis patients, independently associated with ongoing infections, and could be associated with worse prognosis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a QuantiFERON | |
| 650 | 4 | |a infection | |
| 650 | 4 | |a mitogen | |
| 650 | 4 | |a mortality | |
| 650 | 4 | |a outcomes | |
| 700 | 1 | |a Binquet, Christine |e verfasserin |4 aut | |
| 700 | 1 | |a Manoha, Catherine |e verfasserin |4 aut | |
| 700 | 1 | |a Audia, Sylvain |e verfasserin |4 aut | |
| 700 | 1 | |a Simonet-Lamm, Anne-Laure |e verfasserin |4 aut | |
| 700 | 1 | |a Casenaz, Alice |e verfasserin |4 aut | |
| 700 | 1 | |a Sow, Amadou-Khalilou |e verfasserin |4 aut | |
| 700 | 1 | |a Piroth, Lionel |e verfasserin |4 aut | |
| 700 | 1 | |a Blot, Mathieu |e verfasserin |4 aut | |
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